A client is scheduled for a sigmoidoscopy. What instruction should the nurse provide the client in preparation for this diagnostic procedure?

Appeared in: BHU NO-2019

Explanation

A sigmoidoscopy is a procedure to visually examine the rectum and sigmoid colon, which is the lower part of the large intestine.
To ensure a clear and unobstructed view of the intestinal lining, the lower bowel must be completely free of stool.
Administering an enema on the morning of the test is a standard and effective method to cleanse the rectum and sigmoid colon specifically for this procedure.

Option A: A full 24-hour fast is excessive for a sigmoidoscopy. Unlike a full colonoscopy, extensive dietary restrictions are usually not necessary.
Option B: A stool specimen is collected for separate diagnostic tests, such as culture for infection or occult blood testing, not as part of the preparation for a sigmoidoscopy.
Option D: Swallowing a chalk-like substance (barium) is characteristic of an upper GI series or barium swallow, which uses X-rays to examine the esophagus, stomach, and duodenum.

Clinical Relevance

Nursing practice connection: Use the key finding related to Client education for sigmoidoscopy preparation to guide bedside assessment, documentation, and the next nursing action.
Proper patient education on bowel preparation is crucial for the success of a sigmoidoscopy. Inadequate cleansing can obscure the view, leading to a missed diagnosis or the need to repeat the procedure.
Nurses must assess the client's understanding of the instructions and their ability to perform the enema, providing assistance or further education as needed.
What if? If the client was scheduled for a full colonoscopy instead of a sigmoidoscopy, the preparation would be much more extensive, typically involving a clear liquid diet for 1-2 days and drinking a large volume of a special bowel-cleansing solution (lavage).

How to Approach the Question

First, identify the key procedure in the question: 'sigmoidoscopy'.
Recall the purpose of a sigmoidoscopy, which is to visualize the lower part of the colon (sigmoid colon and rectum).
Consider what is necessary to visualize this specific area. The bowel must be clear of stool.
Evaluate each option based on this requirement. An enema is a direct and localized method to cleanse the lower bowel.
Eliminate the other options by identifying the procedures they are associated with: a 24-hour fast is excessive, stool collection is a different test, and swallowing barium is for upper GI studies.

Concept Tested & Keywords

Concept Tested: Client education for sigmoidoscopy preparation
Stem keywords: sigmoidoscopy, instruction, nurse, preparation, diagnostic procedure
Lead-in keywords: What instruction
Negative lead-in flag: false

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 83-85

Practise the full BHU NO-2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.